Pulmonary embolism is when an artery in the lungs suddenly becomes blocked, usually by a blood clot. If a blood clot is large or if there are many blood clots, pulmonary embolism can be fatal. Blood clots in the lungs may cause death to part of the lungs and cause permanent damage to other organs in the body. You don't have to be sick to develop a pulmonary embolism – the condition can occur in healthy people.
Symptoms of Pulmonary Embolism
Symptoms of pulmonary embolism vary depending on the size of the blood clot and the presence of other diseases. Symptoms commonly include:
- sudden shortness of breath, even when resting
- sudden coughing, which may produce blood-stained sputum
- chest pain, which may be under the breast bone or on one side of the chest – the pain does not go away when resting and may worsen when breathing deeply, bending, stooping, coughing or eating; you may experience sharp, stabbing pains and even feel as though you are having a heart attack.
Pulmonary embolism may also be accompanied by other symptoms such as wheezing, lightheadedness, fainting, rapid breathing, irregular or rapid heartbeat, a weak pulse, sweating, clammy skin with a blue tinge, leg pain and anxiety.
Pulmonary Embolism Causes
Pulmonary embolism is caused by an embolus, a material travelling in the bloodstream which gets lodged in an artery in the lungs. This material is often a blood clot but can occasionally be air bubbles, fat from broken bone marrow, amniotic fluid or tumour cells. Pulmonary embolism is usually associated with a blood clot in the deep veins of the legs, known as a deep vein thrombosis, which breaks free and travels to the lungs.
There are certain risk factors which make pulmonary embolism more likely. These include:
- surgery: during surgery involving replacement of hip and knee joints, bone debris can enter the bloodstream and cause a clot
- immobility: long periods of bed rest, such as after surgery or illness, or sitting in the same position during long journeys slows blood flow and increases the risk of clots
- family history: if other family members have had bloods clots or pulmonary embolism, this could indicate an inherited blood-clotting disorder
- valve problems: older people may experience problems with valves in their veins which can interrupt blood flow
- cancer: some cancers, particularly lung, pancreatic and ovarian cancer, along with chemotherapy, may make the blood more likely to clot
- pregnancy: the flow of blood returning from the legs may slow down and pool when the baby presses on blood vessels in the pelvis.
Other risk factors for blood clots include heart disease, stroke, obesity and smoking. Birth control pills and hormone replacement therapy which contain oestrogen may increase clotting factors in the blood.
Pulmonary Embolism Treatment
Pulmonary embolism must be treated quickly to prevent complications and a stay in hospital may be required. Necessary treatment may include:
- anticoagulants: in cases of minor blood clots, the anticoagulant drugs heparin (given as an injection or intravenously) and warfarin (given in pill form) are used to thin the blood and prevent the formation of new blood clots
- clot dissolvers: clot dissolvers, or thrombolytics, may be used to make a blood clot dissolve quickly. These are usually only given when a blood clot is severe and life-threatening, as clots often dissolve of their own accord
- surgery: if a blood clot is very large, it may need to be removed by threading a catheter through the blood vessels; a vein filter, known as an inferior vena cava filter, can be also be fitted in the central main vein to prevent large blood clots in the legs being carried to the lungs – this is usually only performed when anticoagulant drugs are not suitable.
It is important to seek medical attention immediately if you have chest pain, sudden shortness of breath or bloody sputum during coughing. Pulmonary embolism can be life-threatening and requires prompt treatment. You can reduce the risk of pulmonary embolism by taking steps to prevent blood clots in your legs. Wear compression stockings after surgery and exercise your calf muscles during car and plane journeys to encourage blood circulation.
Resources
Mayo Clinic. "Pulmonary Embolism" (Accessed 4th March 2011).
MedlinePlus. "Pulmonary Embolus" (Accessed 4th March 2011).
National Heart Lung and Blood Institute. "Pulmonary Embolism" (Accessed 4th March 2011).
Sharon Kirby - Sharon is a freelance health writer and contributes to various print and online publications. Writing credits include Nursing Times, Good ...
